Provider Demographics
NPI:1205554110
Name:CELESTIN-DALY, TRACY
Entity type:Individual
Prefix:
First Name:TRACY
Middle Name:
Last Name:CELESTIN-DALY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1673 TROY AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11234-1424
Mailing Address - Country:US
Mailing Address - Phone:917-804-4741
Mailing Address - Fax:
Practice Address - Street 1:1673 TROY AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11234-1424
Practice Address - Country:US
Practice Address - Phone:917-804-4741
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-16
Last Update Date:2022-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency